ATLS Practice Test 10th Edition 1

Question 1

1. A base deficit of -4 in a patient with hemorrhagic shock indicates which type of shock?

Accepted Answer

Class 2

Answer

Class 3

Answer

Class 4

Answer

Class 1

Question 2

2. Mildly hypotensive patient, tachycardic, BP returns to normal after 1L fluid bolus but then drops again. What are you going to do?

Accepted Answer

Begin transfusing blood.

Answer

Transfer to higher level of care.

Answer

Distribute a 2nd liter bolus of crystalloid.

Answer

Obtain a CT scan to determine the source of the bleeding.

Question 3

3. A 20-year-old man fell 20 feet through a rotten plank on an old wooden bridge to the rocky stream below. He was taken to the emergency room within 30 minutes, complaining of chest pain. On arrival at the ED, he is hypotensive. What are you going to do?

Accepted Answer

1L bolus crystalloid

Answer

Send to OR

Answer

2L bolus crystalloid

Answer

Crack the chest

Question 4

4. A 30-year-old woman was walking across a busy intersection when she was hit by a van. She has a clearly  broken right femur as well as three broken ribs on the right side. She is in need of a blood transfusion. Which of the following statements is correct?

Accepted Answer

A massive transfusion is defined as >4u pRBC in 1 hour.

Answer

The ACS has created a universal MTP that all trauma centers should follow.

Answer

Everyone who requires a massive transfusion should be given calcium supplements.

Answer

<12u pRBC transfusion in 24 hours would not be considered a massive transfusion.

Question 5

5. A 29-year-old man is diagnosed with scrotum ecchymosis after landing hard on his bike while jumping across rugged terrain in the national forest.

Accepted Answer

A retrograde urethrogram is advised.

Answer

The patient should be instructed to oidv in order to confirm or rule out the presence of gross blood in the urinary tract.

Answer

A suprapubic catheter should be inserted right away.

Answer

If the prostate exam is normal and there is no blood at the urethral meatus, a Foley catheter may be placed as a precaution.

Question 6

6. Two assailants beat a 49 year-old man with a wooden bat in his home during a robbery. He is taken to the emergency department, hemodynamically stable, with hemoptysis and cervical subQ emphysema. Which of the following statements is true?

Accepted Answer

Fiber optic assisted intubation could be used.

Answer

Insert a gastric tube immediately to prevent aspiration.

Answer

Immediately begin needle decompression.

Answer

Bronchoscopy should be avoided because it may aggravate the injury.

Question 7

7. Which of the following statements about the management of the potentially coagulopathic patient is correct?

Accepted Answer

Rotational Thromboelastometry is a point-of-care test that could help guide this patient's treatment.

Answer

Permissive hypothermia permits a low level of hypothermia to reduce the risk of coagulopathy.

Answer

Thromboelastography can take up to 2-3 hours in some labs and should not be performed on patients who require transfer.

Answer

Baseline PLTs, PT/INR, and PTT should be checked within 4 hours of arrival in the ED.

Question 8

8. What type of hemorrhagic shock would cause the GCS to decrease?

Accepted Answer

Class 3

Answer

Class 2

Answer

Class 4

Answer

Class 1

Question 9

9. When one of the rides at the State Fairgrounds malfunctions, a 30-year-old man suffers a deceleration injury. A CXR reveals apical cap and depression of the left main-stem bronchus:

Accepted Answer

This patient's target MAP is 60-70mm Hg.

Answer

Nitroprusside is the preferred medication.

Answer

An upper endoscopy will be performed to confirm the diagnosis.

Answer

An emergency thoracotomy should be performed right away.

Question 10

10. According to the Canadian C-spine Rule, which of the following patients would not require radiographic evaluation?

Accepted Answer

A 35-year-old woman with delayed-onset neck pain who can actively rotate her neck 45 degrees to the left and right.

Answer

A 23-year-old man with tenderness in the midline of his cervical spine.

Answer

A 12-year-old boy who fell 3 1/2 feet.

Answer

A 42-year-old woman was rear-ended by a city bus.